Warning issued after surge in ‘severe opioid overdoses’ linked to nitazenes in Penrith area

The alarm has been raised following a surge in “severe opioid overdoses” within one Aussie community with warnings a US-style epidemic could be near.

Aussie area faces ‘severe opioid overdoses’.

NSW Health has raised the alarm following a surge in “severe opioid overdoses” within the Penrith area over the past month.

The emergence of nitazenes in drug samples linked to approximately 20 overdoses reported in the Nepean Blue Mountains Local Health District has prompted ongoing investigations into these cases.

Nitazenes, identified as potent synthetic opioids, surpass the strength of fentanyl and are hundreds of times more potent than heroin.

They pose an elevated risk of respiratory depression compared to other opioids.

NSW Health has raised concerns regarding a surge in severe opioid overdoses in the Penrith area. Picture: NCA NewsWire / Gaye Gerard

Dr Hester Wilson, NSW Health Chief Addiction Medicine Specialist, underscored the gravity of the situation, stating, “Nitazenes are extremely potent.”

“It is crucial that individuals are able to identify the signs of an opioid overdose promptly and are familiar with appropriate responses,” Dr Wilson said.

Characteristic symptoms of opioid overdose, such as pinpoint pupils, lethargy, loss of consciousness, respiratory depression, and cyanosis, can be life-threatening.

Dr Wilson highlighted the unpredictable nature of illicit drug supply, emphasizing, “One of the dangers of illicit drug supply is the strength and contents of the substance you are getting is unknown and can be inconsistent.”

Nitazenes, a potent synthetic opioid, have been identified in drug samples linked to approximately 20 overdoses in the Nepean Blue Mountains Local Health District. Picture: Getty Images

In response to this detection, Dr Wilson recommended that individuals who use drugs like heroin carry naloxone, stressing its lifesaving potential.

Naloxone, available as a take-home measure, can temporarily reverse opioid overdoses, including those involving nitazenes, which persist longer in the body than heroin.

Immediate medical assistance via triple-0 is advised following naloxone administration, with Dr Wilson reassuring, “You won’t get into trouble for seeking medical care.”

Accessible in the form of nasal spray or injection, take-home naloxone is obtainable from select pharmacies and health services.

What are nitazenes?

It’s believed these substances have infiltrated the market disguised as heroin and other drugs like ketamine, raising significant concerns among health authorities regarding the potential dangers associated with their use.

Earlier this week, The Royal Australian College of General Practitioners (RACGP) shed light on this alarming development, drawing parallels between nitazenes and the infamous opioid fentanyl, which has wrought havoc in North America.

“Fentanyl is the prescription opioid that caused Prince’s death in 2016,” highlights the RACGP.

Nitazenes are similar to, if not stronger than, fentanyl, which has been wreaking havoc in the United States for almost a decade. Picture: AFP

“Some [nitazenes] are similar to fentanyl in strength, while others can be up to 50 times stronger than fentanyl.”

Unlike morphine or heroin derived from the opium poppy, both fentanyl and nitazenes are classified as highly potent “synthetic” opioids, synthesised in labs.

Illegally manufactured fentanyl has proven catastrophic in North America, dominating drug-related deaths in the US and Canada.

While Australia has seen limited evidence of fentanyl’s widespread availability and declining heroin-related deaths, the emergence of nitazenes presents a new challenge, the RACGP argues.

Developed and tested in the 1950s by pharmaceutical companies, nitazenes were sidelined due to safety concerns.

However, recent years have witnessed a surge in nitazene-related fatalities in the UK and the US.

A person lies on the street in the Old Town Chinatown neighbourhood in downtown Portland, Oregon, where hard drugs were decriminalised in Oregon three years ago after synthetic opioids took hold of the streets. Picture: AFP

“These substances vary in potency, with some comparable to fentanyl and others surpassing its strength,” notes the RACGP.

Yet, unlike fentanyl, the understanding of nitazenes remains relatively limited, compounded by challenges in detection.

Reports indicate nitazenes appearing in falsified pharmaceutical products and contaminating various drugs, including heroin, methamphetamine, MDMA, and ketamine. Additionally, there are instances of deliberate purchases of nitazenes online.

The broad spectrum of potential users, ranging from occasional drug users at music festivals to regular injectors, underscores an urgency for diverse intervention strategies, the RACGP pleads.

NSW Health has also warned heroin, cocaine, meth and MDMA users that their products may contain nitazenes, presenting a potentially deadly cocktail.

Recent warnings

In August 2023, Australian policing expert Alex Caruana warned synthetic opioids – namely fentanyl – could “annihilate” Australian communities, should they become widely available.

“In places like Wagga and Dubbo where we can see what ice is doing to the organisation, we can see these pharmaceuticals are also a problem,” the Australian Federal Police member and head of the Australian Federal Police Association told news.com.au.

“If non-pharmaceutical fentanyl gets into those rural areas, it’s going to annihilate them. There’s already a scourge there with the ice, and it’s really going to make an impact.”

He feared that bad actors were closely monitoring attrition rates and staff and resource shortages within the AFP, both domestically and abroad.

There are fears Australian communities are unprepared for an opioid epidemic like what has been seen in US cities like Baltimore (pictured). Picture: AFP

“(The suppliers) are the scum of the earth, and they will exploit those weaknesses – that’s what these crooks do – of course, they’re paying attention to this,” he said.

Former Australian fentanyl addict who found himself at ground zero of the American fentanyl epidemic in Baltimore in 2015 also agreed Australia is “not ready” for an influx of the synthetic drugs.

“I will never forget seeing the crisis in all its glory,” Darren Keogh, who has since moved back to Western Australia, told news.com.au last year.

“Once you’ve had a good dose of opiates, it’s not something you can put down and forget about – it makes you feel good, it makes you feel warm and fuzzy, and like you’ve got it together.”

“You could make a phone call, you could walk out on the street, you know, you could go into the gang areas because all the gangs on every second corner are selling it.

Darren said what he saw in Baltimore was far worse than Victoria in the 1990s when heroin prices plummeted, and the state saw overdose rates reach 6.5 people per 100,000.

“We are not prepared for this, and if it does take off, we will not have the education and resources to stop it,” he lamented.

“I don’t think people understand how serious it can become because, you know, I’ve actually seen people overdose on the streets – just collapse and die.”